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			<option value="si" name="si" selected="selected">SI</option>
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	  <h2>重症监护室死亡率与APACHE II评分</h2> 
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	<form name="theform" action="get" id="theform">
		<table cellspacing="0" cellpadding="0" border="0">
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				<td valign="top" class="">患者有器官功能不全病史?</td>
				<td class="">
				<ul>
					<li><label> <input type="radio" value="6" name="immuno" id="immuno"> 是的，且为急诊手术后转入</label></li>
					<li><label> <input type="radio" value="5" name="immuno" id="immuno"> 是的，且为非手术后转入</label></li>
					<li><label> <input type="radio" value="2" name="immuno" id="immuno"> 是的，且为择期手术后转入</label></li>
					<li><label> <input type="radio" value="0" name="immuno" id="immuno"> 否</label></li>
				</ul>
				</td>
			</tr>
			<tr>
				<td class="">患者有急性肾功能衰竭?</td>
				<td class=""><label class=""> <input type="checkbox" value="1" name="arf" id="arf"> 是</label></td>
			</tr>
			<tr class="req">
				<td class="">年龄</td>
				<td class=""><input type="text" name="age" id="age"> 岁</td>
			</tr>
			<tr class="req">
				<td class="">体温（肛温，摄氏度）</td>
				<td class="short60"><input type="text" name="temp" id="temp"> °C 或 °F (其中一个!)</td>
			</tr>
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				<td class="">平均动脉压(MAP)</td>
				<td class=""><input type="text" name="map" id="map"></td>
			</tr>
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				<td class="">动脉血 pH</td>
				<td class=""><input type="text" name="ph" id="ph"></td>
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			<tr class="req">
				<td class="">心率</td>
				<td class=""><input type="text" name="hr" id="hr"> bpm</td>
			</tr>
			<tr class="req">
				<td class="">呼吸频率</td>
				<td class=""><input type="text" name="rr" id="rr"> bpm</td>
			</tr>
			<tr class="req">
				<td>钠 （血清）</td>
				<td><input type="text" name="na" id="na"> <label for="na" class="na">mmol/L</label></td>
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			<tr class="req">
				<td>钾 （血清）</td>
				<td><input type="text" name="pot" id="pot"> <label for="pot" class="k">mmol/L</label></td>
			</tr>
			<tr class="req">
				<td>肌酐 （血清）</td>
				<td><input type="text" name="cr" id="cr"> <label for="cr" class="cr">μmol/L</label></td>
			</tr>
			<tr class="req">
				<td>血球压积</td>
				<td><input type="text" name="hct" id="hct"></td>
			</tr>
			<tr class="req">
				<td>白细胞计数</td>
				<td class="short60"><input type="text" name="wbc" id="wbc"> x10<sup>3</sup> cells / mm<sup>3</sup></td>
			</tr>
			<tr class="req">
				<td>格拉斯哥昏迷评分</td>
				<td><input type="text" name="gcs" id="gcs"> 分</td>
			</tr>
			<tr>
				<td>肺泡-动脉氧分压差（如FiO2 ≥ 0.5请输入）</td>
				<td><label> <input type="text" name="aagrad" id="aagrad"> mm Hg</label></td>
			</tr>
			<tr>
				<td>PaO2 (如 FiO2 &lt; 0.5请输入)</td>
				<td><label> <input type="text" name="pao2" id="pao2"> mm Hg</label></td>
			</tr>
			<tr class="answer">
				<td>Apache II 评分</td>
				<td><input type="text" readonly="readonly" value="点击查看" name="result" id="result"> 分</td>
			</tr>
			<tr class="answer">
				<td colspan="2"><div id="resultmsg"> </div></td>
			</tr>
		</tbody></table>
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